scholarly journals Improving Insomnia in Primary Care Patients a Randomized Controlled Trial of Nurse-Led Group Treatment: A Literature Review

2020 ◽  
Vol 1 (1) ◽  
pp. 19-24
Author(s):  
Alwan Revai
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Group Treatment ◽  
Control Groups ◽  
Stockholm County ◽  
Treatment As Usual ◽  
Treatment Groups ◽  
Primary Health ◽  
Significant Difference

Introduction: Insomnia is generally defined as complaints of poor or unsatisfactory sleep, which can include difficulty initiating sleep, awakening after sleep onset, poor sleep quality, early morning awakenings, short sleep times, short total sleep times and daytime consequences. Chronic insomnia is a common problem in primary health care, affecting 10 - 19% of those seeking primary care. Method: Patient is a randomly selected sample of 165 people and divided into 2 groups, namely 90 treatment groups and 75 control groups in seven routine primary health care in Stockholm County, Sweden between August 2011 and June 2014. The intervention to be given was in the treatment group given the intervention consisting of a group treatment program for insomnia based on the CBT-I technique while the control group was free to undergo insomnia treatment as usual. Result: The formulation of the research problem is to compare how the effect of nurse-led group treatment with the effect of treatment as usual in routine primary health care in Stockholm County, Sweden. In this study, the researcher determined a sample of 165 people who met the research requirements, and divided respondents randomly (single-blinded) consisting of 90 treatment groups and 75 control groups. Conclusion: There was a significant difference between the treatment of insomnia with cognitive therapy and the treatment of insomnia with drugs. So that we can reduce the long-term effects of using drugs to treat insomnia.

scholarly journals Levels of engagement in primary health care professionals: a comparative study in two Brazilian municipalities

2019 ◽  
Vol 23 (3) ◽  
Author(s):  
Luciano Garcia Lourenção ◽  
Albertina Gomes da Silva ◽  
Márcio Andrade Borges
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Community Health ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Significant Difference

Abstract Objective: To evaluate the levels of engagement of Primary Health Care professionals in two municipalities. Methods: A descriptive study was carried out with 238 health professionals who work in the Primary Care services of two municipalities in the state of São Paulo. The engagement dimensions of the professionals were investigated through the Utrecht Work Engagement Scale. Results: Female predominance (82.8%), age under 40 years (52.9%). Median working time in primary care of three (municipality A), four years (municipality B). Significant difference in levels of engagement in both municipalities. Community health agents presented mean scores in all dimensions. Significant difference in levels of engagement according to professional category in all dimensions. Conclusion and implications for practice: Municipal health professionals with 100.0% coverage by the Family Health Strategy tend to have higher levels of engagement. Nurses presented greater engagement; community health workers reached lower levels than other professionals did. Engagement is an indicator that contributes to the evaluation of the workforce in the Primary Health Care services and can be used to direct strategies that improve the levels of dedication, absorption and vigor of the professionals, benefiting the organization of the primary care services.

Brazilian National Household Health Survey and PCAT: the case of Mato Grosso do Sul, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F Pinto ◽  
D Soranz ◽  
L J Santos ◽  
M S Paranhos ◽  
L S Malta ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Data Collection ◽  
Health Survey ◽  
Household Surveys ◽  
Mato Grosso ◽  
Primary Health ◽  
The World ◽  
Mato Grosso Do Sul

Abstract Brazil is divided into five administrative regions, 27 federation units and 5,570 municipalities. Mato Grosso do Sul is one of the states located in the Midwest region and has 1.6 million km2 and a resident population of 2.8 million inhabitants, that is, it has an even lower demographic density than its region - only 7.8 inhabitants/km2. Mato Grosso do Sul has part of the Pantanal, a biome considered the largest continuous floodplain in the world, rich in biodiversity. For this reason, displacements for data collection in household surveys combine roads and rivers. In 2019, the Brazilian National Institute of Geography and Statistics (Istituto Nazionale di Statistica del Brasile) in partnership with the Ministry of Health launched the world's largest household sample survey, the National Health Survey (PNS-2019), in which part of its questions included the use of Primary Care Assessment Tool (PCAT, adult version), created by professors Barbara Starfield and Leiyu Shi in the 2000s. IBGE interviewers visited more than 100,000 households across the country. In Mato Grosso do Sul, more than 3,000 households were surveyed. In this work, we present the data collection instrument used by IBGE and its multiple analysis possibilities in the scope of primary health care, crossing the variables from other questionnaire modules in order to compare the results from Brazil with the state of Mato Grosso do Sul and its capital, Campo Grande. Developing a baseline and measuring the attributes of primary health care in each of the Brazilian states is another step towards giving health policy accountability, towards strong primary care. IBGE's experience in household surveys and innovation in data collection in primary care is an example for the world that yes, it is possible to develop statistically representative national sample surveys and make them perennial in their regular household surveys, by the time World Health Organization (WHO) discusses universal health coverage. Key messages Evaluation of primary care using an internationally validated instrument is possible on national bases with random household sample surveys. A questionnaire elaborated academically can be used as an instrument of public policy to evaluate nationwide health services.

scholarly journals Primary care organizational model mix and avoidable hospitalization: an ecological study in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Pinto ◽  
J V Santos ◽  
M Lobo ◽  
J Viana ◽  
J Souza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Healthcare ◽  
Pay For Performance ◽  
Care Quality ◽  
Organizational Model ◽  
Avoidable Hospitalizations ◽  
Primary Health ◽  
Age And Sex

Abstract Background In Portugal, there are different organizational models in primary health care (PHC), mainly regarding the payment scheme. USF-B is the only type with financial incentives to the professional (pay-for-performance). Our goal was to assess the relationship between groups of primary healthcare centres (ACES) with higher proportion of patients within USF-B model and the rate of avoidable hospitalizations, as proxy of primary care quality. Methods We conducted a cross-sectional study considering the 55 ACES from mainland Portugal, in 2017. We used data from public hospitalizations to calculate the prevention quality indicator (avoidable hospitalizations) adjusted for age and sex, using direct standardization. The main independent variable was the proportion of patients in one ACES registered in the USF-B model. Unemployment rate, proportion of patients with family doctor and presence of Local Health Unit (different organization model) within ACES were also considered. The association was assessed by means of a linear regression model. Results Age-sex adjusted PQI value varied between 490 and 1715 hospitalizations per 100,000 inhabitants across ACES. We observed a significant effect of the proportion of patients within USF-B in the crude PQI rate (p = 0.001). However, using the age-sex adjusted PQI, there was not a statistical significant association (p = 0.504). This last model was also adjusted for confounding variables and the association remains non-significant (p = 0.865). Conclusions Our findings suggest that, when adjusting for age and sex, there is no evidence that ACES with more patients enrolled in a pay-for-performance model is associated with higher quality of PHC (using avoidable hospitalizations as proxy). Further studies addressing individual data should be performed. This work was financed by FEDER funds through the COMPETE 2020 - POCI, and by Portuguese funds through FCT in the framework of the project POCI-01-0145-FEDER-030766 “1st.IndiQare”. Key messages Adjusting PQI to sex and age seems to influence its value more than the type of organizational model of primary health care. Groups of primary healthcare centres with more units under the pay-for-performance scheme was not associated with different rate of avoidable hospitalizations.

The Preparedness of Primary Health Care Network in terms of Emergency Risk Communication: A Study in Iran

2021 ◽  
pp. 1-10
Author(s):  
Zeinab Bagheri ◽  
Tahereh Dehdari ◽  
Masoud Lotfizadeh
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Risk Communication ◽  
Health Care Facilities ◽  
Effective Response ◽  
Care Network ◽  
Primary Health ◽  
Significant Difference ◽  
Health Care Network ◽  
Control And Prevention

Abstract Objective: Emergency Risk Communication (ERC) is known as 1 of the important components of an effective response to public health emergencies. In this study, we aimed to investigate the preparedness of the Primary Health Care Network (PHCN) of Iran in terms of the ERC. Methods: This study was conducted in 136 Primary Health Care Facilities (PHCFs) affilated to Shahrekord University of Medical Sciences, Chaharmahal and Bakhtiari Province, Iran. Data in terms of ERC were collected using a checklist developed by the Center of Disease Control and Prevention (CDC). Results: The findings of the study revealed that 65.9% of the PHCFs had low preparedness in terms of the ERC, 33.3% had a moderate level and 0.8% had high preparedness in this regard. There was a significant difference between the level of ERC and the history of crisis in the past year, PHCF type, and the education level of the responsible employees in the crisis unit in the PHCF. Conclusions: The results showed that the PHCFs studied need to increase their capacity and capability in the field of ERC. Further efforts to provide ERC components may increase the preparedness of PHCN in Iran in terms of the ERC.

scholarly journals Access to medicines by patients of the primary health care in the Brazilian Unified Health System

2017 ◽  
Vol 51 ◽  
pp. 20s ◽  
Author(s):  
Juliana Álvares ◽  
Augusto Afonso Guerra Junior ◽  
Vânia Eloisa de Araújo ◽  
Alessandra Maciel Almeida ◽  
Carolina Zampirolli Dias ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Developed Countries ◽  
Access To Medicines ◽  
Essential Medicines ◽  
Unified Health System ◽  
Primary Health ◽  
Significant Difference ◽  
Good For

OBJECTIVE: To evaluate the access to medicines in primary health care of the Brazilian Unified Health System (SUS), from the patients’ perspective. METHODS: This is a cross-sectional study that used data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Services, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), conducted by interviews with 8,591 patients in cities of the five regions of Brazil. Evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, accessibility, accommodation, acceptability, and affordability. Each dimension was evaluated by its own indicators. RESULTS: For the “availability” dimension, 59.8% of patients reported having full access to medicines, without significant difference between regions. For “accessibility,” 60% of patients declared that the basic health unit (UBS) was not far from their house, 83% said it was very easy/easy to get to the UBS, and most patients reported that they go walking (64.5%). For “accommodation,” UBS was evaluated as very good/good for the items “comfort” (74.2%) and “cleanliness” (90.9%), and 70.8% of patients reported that they do not wait to receive their medicines, although the average waiting time was 32.9 minutes. For “acceptability,” 93.1% of patients reported to be served with respect and courtesy by the staff of the dispensing units and 90.5% declared that the units’ service was very good/good. For “affordability,” 13% of patients reported not being able to buy something important to cover expenses with health problems, and 41.8% of participants pointed out the expense with medicines. CONCLUSIONS: Results show 70%–90% compliance, which is compatible with developed countries. However, access to medicines remains a challenge, because it is still heavily compromised by the low availability of essential medicines in public health units, showing that it does not occur universally, equally, and decisively to the population

scholarly journals Cross-cultural adaptation of the primary health care satisfaction questionnaire

2014 ◽  
Vol 27 (5) ◽  
pp. 419-426 ◽  
Author(s):  
Elisabete Pimenta Araujo Paz ◽  
Pedro Miguel Santos Dinis Parreira ◽  
Alexandrina de Jesus Serra Lobo ◽  
Rosilene Rocha Palasson ◽  
Sheila Nascimento Pereira de Farias
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Cultural Adaptation ◽  
Care Service ◽  
Cross Cultural ◽  
Care Services ◽  
Primary Health

Objective To develop the cross-cultural validation and assessment of the psychometric properties of the Questionnaire about the quality and satisfaction dimensions of patients with primary health care. Methods Methodological cultural adaptation and assessment study of the psychometric properties, involving 398 users from a primary care service. The construct validity was verified through principal components factor analysis and internal consistency assessment as determined by Cronbach’s alpha, using SPSS. Results A factorial structure was identified that is equivalent to the original instrument, showing six factors that explain 70.81% of the total variance. All internal consistency coefficients were higher than 0.84, indicating appropriate psychometric properties. Conclusion The results show that the Brazilian Portuguese version of the instrument is culturally and linguistically appropriate to assess the satisfaction of users attended in primary care services.

scholarly journals Promoting cross-jurisdictional primary health care research: developing a set of common indicators across 12 community-based primary health care teams in Canada

2018 ◽  
Vol 20 ◽  
Author(s):  
Sabrina T. Wong ◽  
Julia M. Langton ◽  
Alan Katz ◽  
Martin Fortin ◽  
Marshall Godwin ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Working Group ◽  
Scale Up ◽  
Data Sources ◽  
Knowledge Generation ◽  
Community Based ◽  
Primary Health ◽  
The Impact

AbstractAimTo describe the process by which the 12 community-based primary health care (CBPHC) research teams worked together and fostered cross-jurisdictional collaboration, including collection of common indicators with the goal of using the same measures and data sources.BackgroundA pan-Canadian mechanism for common measurement of the impact of primary care innovations across Canada is lacking. The Canadian Institutes for Health Research and its partners funded 12 teams to conduct research and collaborate on development of a set of commonly collected indicators.MethodsA working group representing the 12 teams was established. They undertook an iterative process to consider existing primary care indicators identified from the literature and by stakeholders. Indicators were agreed upon with the intention of addressing three objectives across the 12 teams: (1) describing the impact of improving access to CBPHC; (2) examining the impact of alternative models of chronic disease prevention and management in CBPHC; and (3) describing the structures and context that influence the implementation, delivery, cost, and potential for scale-up of CBPHC innovations.FindingsNineteen common indicators within the core dimensions of primary care were identified: access, comprehensiveness, coordination, effectiveness, and equity. We also agreed to collect data on health care costs and utilization within each team. Data sources include surveys, health administrative data, interviews, focus groups, and case studies. Collaboration across these teams sets the foundation for a unique opportunity for new knowledge generation, over and above any knowledge developed by any one team. Keys to success are each team’s willingness to engage and commitment to working across teams, funding to support this collaboration, and distributed leadership across the working group. Reaching consensus on collection of common indicators is challenging but achievable.

scholarly journals Partnership in Practice: a multidisciplinary approach to quality improvement in primary health care

1995 ◽  
Vol 19 (6) ◽  
pp. 371-371
Author(s):  
Michael Phelan
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
General Practitioners ◽  
Multidisciplinary Approach ◽  
Professional Groups ◽  
Primary Health ◽  
Audit Team

This one day seminar was arranged by the King's Fund Organisational Audit team (KFOA), to take a multidisciplinary view of quality improvement in primary care. Despite the title of the day all the speakers were general practitioners and managers, and input from other professional groups was limited to questions and comments from the audience of nearly 200.

scholarly journals Effect of implementation intention on walking in people with diabetes

2020 ◽  
Vol 54 ◽  
pp. 103
Author(s):  
Marco Antonio Vieira da Silva ◽  
Thaís Moreira São-João ◽  
Marilia Estevam Cornelio ◽  
Fábio Luiz Mialhe
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Leisure Time Physical Activity ◽  
Intervention Strategy ◽  
Intervention Group ◽  
Implementation Intention ◽  
Control Group ◽  
Primary Health ◽  
Significant Difference

OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

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